There When You Need It? the Attack on Health Care Continues

insight: the latest attack • fixing medicare• advocating for seniors analysis: medicare's origins • lrb in wonderland • health care around the world spring 2009 • • • • insight & analysis U nan alberta federationi o of labour publicationn There When You Need It? the attack on health care continues spring 2009 | union 3 contents spring 2009 credits This issue's contributors 1 First Thoughts | gil mcgowan david eggen • jason foster samara jones • tom fuller feature articles jim selby • michelle westgeest art director 2 The Stealth Attack On robert andruchow Health Care in Alberta VisCom Design david eggen, Executive Director, Friends of Medicare www.viscom.ca design + illustration 7 Fixing Medicare kathleen jacques Picking The Right Mechanic jason foster Union is a seasonal publication of the Alberta Federation of Labour 12 Fighting For Good Care (AFL). It is a magazine intended Interview with Lynda Jonson, seniors’ advocate and activist to provide insight and analysis samara jones into ongoing social, economic and political issues of concern to union burning issue activists, officers and staff. The 16 Cure for “Superbugs”? Clean Hospitals! AFL is Alberta’s largest central tom fuller labour body representing more than 137,000 Alberta workers and labour law their families. 19 Labour Relations Nonsense Labour Law Through the Looking Glass Union is published three times a michelle westgeest year (spring, fall, winter) in elec- tronic and paper versions. international It is distributed free of charge 23 Is Health Care Better Elsewhere? to subscribers. Subscription samara jones requests can be made online at www.afl.org or by contacting history the AFL office. Union is edited 26 Overview Of Canada’s Medicare System collectively by the senior staff at jim selby the Alberta Federation of Labour. alberta federation of labour 10654–101 Street Edmonton, AB T5H 2S1 Phone: (780)483-3021 Toll Free: 1-800-661-3995 Fax: (780)484-5928 Email: [email protected] First Thoughts this issue’s theme: s it just me or does seem that every three years or so Albertans have to beat backI another Tory attempt to privatize our health- care system? No, that perception is correct The Ongoing Attack on Medicare – they have made repeated attempts to privatize, despite Alber- Canadians believe so strongly in public health care that tans’ insistence that they stop. it has become part of our identity. In our minds it is what sets us apart from the Americans. The real picture We hate to have to report that the Conservatives are up to no is actually more complex than our self-congratulatory good again. And, this latest attack on Medicare may end up visions. Yet, there is much to admire and honour in our being the most difficult to defeat yet. Unlike the last time, they health-care system. Which is why we need to understand are not putting out a clear plan or package. Instead, they are the risks to Medicare and consider options that can build, dribbling it out in pieces — some cutbacks to seniors’ benefits rather than undermine, it. Hence, this issue. here, some opening of doors to private insurance there — The Friends of Medicare’s David Eggen starts us off by and before you know it, we are on our way to an American- offering an account of what the Conservatives are up to style system. these days and how we can mobilize to stop them. But we all know that stopping them isn’t enough. So, Jason But we should not get caught in the trap of defending every- Foster examines some of the big ideas — some smart, thing about our current health-care system. Medicare is in some not-so-smart — that could reform Medicare. need of reform, but it needs to be the kind of reform that improves and expands health-care access for Canadians. Tom Fuller highlights an under-reported risk to health care - the rise of superbugs and how government cutbacks increase the risk. We have to talk about the threats to it, but also what else we can do to strengthen it for the 21st century. That is the conver- Showing us how we can all make a difference, Samara sation this issue of Union hopes to start. Jones interviews a Hinton woman who has committed her life to advocating for seniors. In a second piece, she Enjoy your reading. takes a look at health-care systems in Europe. Jim Selby has us look back at the political origins of Medicare to remind us of what we can achieve together. Gil McGowan President The issue also continues Michelle Westgeest’s series, part of our Board Watch Project, examining the foibles of the Labour Relations Board. Over the next few months, all of us will have to do our bit to help defend Medicare against further privatization. Hopefully this issue of Union will inform and inspire you in your efforts. We hope you enjoy this issue of Union. spring 2009 | union 1 The Stealth Attack On Health Care In Alberta david eggen 2 union | spring 2009 feature report The Stelmach Conservative government has been making sweeping changes to Alberta’s public health system, but they’ve been doing their very best to NOT tell anyone about it. Health and Wellness Minister Ron Liepert has basically admitted as much. He told the Edmonton Journal that the “third way” failed in part because it was unveiled as one entire package, vulner- able to criticism. “People were allowed to pick at certain things they didn’t like, highlight it and then scare government off, and there wasn’t the political will to follow through,” Liepert said. It is interesting to note that Ron Liepert, a relatively new member of cabinet, before his election as an MLA worked on the Mazankowski report, which was the 2001 plan for privatizing health care and getting people to pay directly for health costs. Liepert is considered tight lipped and tough talking. However, he has promised to “unveil a new model to ensure delivery of health services is more effective and efficient.” Up until now, though, the government hasn’t been at all upfront about what the “new model” will look like. In the midst of the radio silence, changes to health care have been coming hard and fast. Liepert lost little time in clearing the way by firing all the top brass in the province’s nine health regions and putting the whole system all under the new “superboard”, Alberta Health Services. It was revealed shortly after that the Board signed an agreement to do anything and everything the health minister says. Liepert is always quick to say his plan is NOT health-care privatization, but he has never been quite able to say exactly what it IS. We need to look at some of the steps the government has taken in the past year. Who’s On Board? For example, who has Liepert appointed to his new superboard? Ken Hughes, the chairman, is a former Conservative MP and a private insurance company owner and investor. Liepert picked Charlotte Robb as his first CEO and she came over from one of Alberta’s largest private health corporations, Dynalife, the diagnostic giant. When Liepert and Hughes announced their hand-picked board members in November, almost all of them were business people with little medical experience. Except of course Tony Frances- chini from Stantec, the engineering company that has many contracts with the health regions. Another member, Jim Clifford, is in New Jersey where he has been working for private American health-care companies. spring 2009 | union 3 putting the squeeze NDP Leader Brian Mason told the Journal that the people on alberta’s nurses picked for the Board were “the clearest signal yet” the government is going to an American-style private health-care system. The McKinsey Report (titled: Provincial Service Optimiza- tion Review: Final Report) was carefully edited. But one Multinational Companies thing it does openly talk about is how to deal with the Provide The Expertise nursing shortage. Huge multinational consulting corporations Deloitte and The report says the province is short 1,500 nurses now McKinsey & Company are clearly the planning brains behind which could grow to over 6,000 nurses short by 2020. It the changes in health care. The government commissioned a offers to address this shortage in the following recom- report from McKinsey that would be the blue print for health- mendation: “Deepen initiatives and incentives to increase care changes. productivity.” The report proposes “increasing the num- ber of work hours required to earn benefits and replacing It’s clear that what he finally revealed – the “Service Optimi- part-time/overtime incentives with initiatives to promote zation Review” – was a carefully sanitized document. There full-time employment.” wasn’t any mention of McKinsey or who the authors were. It’s also clear that much more was taken out of the document. Yet In other words, make nurses work longer to get the ben- what remains is still quite instructive in terms of the govern- efits they deserve. How will that help attract and retain ment’s plans for health care (see sidebar). nurses during serious nursing shortage? Besides McKinsey, there was also a restructuring plan from Deloitte, who have an interesting approach to health care. At a recent health conference in Toronto, a Deloitte expert offered help protect medicare! up their analysis on the topic, “The need for disruptive change ! join the friends of medicare fight! in the health-care industry”. Friends of Medicare is ramping up and preparing to cam- Few Albertans could have imagined bigger disruption than paign on alerting EVERY Albertan to what the Stelmach rapidly shutting down all the health regions and setting up the government is trying to slide through on health care.

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